CDH 4.8

Question 1

What is the most common cancer in kids?

Answer 1

Leukaemia

Question 2

What are the oral features of malignancy?

Answer 2

Unexplained swelling 
Unusual alveolar bone loss 
Abnormal tooth mobility 
Abnormal eruption patterns associated with bone loss
Non-healing ulcers 
Spontaneous gingival bleeding

Question 3

What are dental problems associated with cancer treatment?

Answer 3

Microdontia 
Root stunting 
Hypodontia 
Hypoplasia 
Delayed exfoliation of primary teeth

Question 4

What are oral problems associated with cancer treatment?

Answer 4

Mucositis = risk of acute infection 
Salivary changes
Glossitis 
Taste changes 
Dysphagia 
Changes in oral flora - increased susceptibility to disease/ candida 
Jaw pain 
Trismus

Question 5

When does mucositis and ulceration occur after 1.chemo and 2.radiotherapy?

Answer 5

1. 3-10 days

2. 12-15 days

Question 6

How is ulceration and mucositis relieved after chemo and radiotherapy?

Answer 6

Avoid spicy hot foods
Smooth fillings/teeth 
Lignocaine lolly/ benzocaine gel 
Ice chips = topical pain relief 
CHX or difflam mouthwash 
Biotene bioextra = artificial saliva
Manage infections using antifungals

Question 7

How is oral HSV treated?

Answer 7

Topical or systemic aciclovir

Question 8

How is oral candida treated?

Answer 8

Miconazole gel 5ml QDS

Fluconazole suspension 50mg/ml once daily

Question 9

How long after radiotherapy has started and finished do salivary changes occur?

Answer 9

14 hours after first dose

Can last for 2 years post tx

Question 10

What is the consequence of salivary changes in the mouth with chemo and radiotherapy?

Answer 10

Increases risk of caries and TSL, therefore consider higher fluoridated toothpaste